The Impact of a Visual Remote Patient Monitoring Device (LEAF) on Hospital-Acquired Pressure Injuries (HAPI)

Problem Statement: The Critical Care Department at a large academic hospital in the Southeast has experienced a significant increase in healthcare-acquired pressure injuries (HAPIs), contributing to elevated mortality rates. Factors such as insufficient adherence to turning protocols and resource limitations impact patient safety, thus increasing the potential for adverse outcomes and increased costs. Purpose: The purpose of this DNP scholarly project was to evaluate the impact of a turn monitoring device, specifically the LEAF system by Smith and Nephew, on HAPI incidence in the critical care setting. The project aimed to address the identified barriers to compliance, enhance patient safety, and improve outcomes by providing visual cues to nursing staff for timely patient turns. Methods: A pre- and post- intervention design was utilized. Participants were utilized from an acute care hospital setting. Inclusion Criteria: Participants eligible for inclusion in this project were individuals receiving care within the Critical Care Department at the designated site throughout the evaluation period. The Critical Care Department encompasses both the Intensive Care Unit (ICU) and Intermediate Intensive Care Unit (IICU). Inclusion criteria consider patients with a Braden Score of eighteen or lower, excluding those with chest wounds impeding sensor adherence or explicit directives from the attending physician to refrain from turning. Analysis: The LEAF system demonstrated a transformative impact on turn compliance and hospital-acquired pressure injuries (HAPIs) in the critical care setting. The pre-intervention compliance of 32.8%, with 72% of patients remaining supine for more than two hours, highlighted significant risks associated with inadequate repositioning. Post-intervention, compliance surged to 90.6%, and HAPI incidence dropped from 6% to 1%, an 83% reduction. Statistical analysis confirmed the significance of these outcomes, linking the intervention to enhanced patient outcomes and reduced healthcare costs. Additionally, staff perceptions shifted markedly, with 92% post-intervention agreeing that the system effectively supported their workflows, compared to just 12.9% pre-intervention. Implications for Practice: The findings emphasize the critical role of wearable monitoring technology in addressing compliance gaps in pressure injury prevention. By alleviating cognitive burdens and promoting accountability, systems like LEAF not only enhance patient safety but also streamline clinical workflows. Healthcare institutions should consider adopting similar innovations, alongside fostering staff education and engagement, to ensure successful implementation and sustainability. The economic benefits further justify the investment, showcasing significant cost savings and reduced morbidity associated with HAPIs. These insights advocate for integrating technology-driven solutions into standard care protocols, particularly in high-risk environments like critical care.